occasional notes about random things

Health

23 September 2013

I know I've groused a bit about how long it takes to do - or get certain things done here. But I have to say that I find myself quite impressed with the efficiency of two particular “things” here: (a) immigration-related medical exams and (b) the trains, which really do seem to run on time! More about the trains later ....

First, for some context: In order to stay in China for any period of time as a noncitizen, you have to have a work and/or resident permit. In order to get a work or resident permit, you have to get a medical exam, here -- in China -- by a specially-designated medical facility. (The exact facility depends on where you intend to live.) I’d heard quite a variety of things about the exam, so wasn’t sure exactly what to expect. I am glad that I read about it – including the conflicting info – before I went, because I was more prepared than I might have been.

My exam was scheduled for early morning the Monday after we arrived. The facility was about 50 minutes away from our place, so I got to see another part of the city during the drive (and discovered PetZoo, the largest pet supply store in the city, which was fortuitous.) Thankfully, the immigration services provider had someone meet me there, because I could not have communicated or understood how to fill out the forms without that support. When I got there, I wasn’t sure exactly what to do, but there was a line snaking its way out the door, so I stood in it, holding my nine passport pictures (required), and my passport, then texted my designated contact, who promptly stood up in the waiting room and met me. Yep, I was in the right line. She took my passport and stash of pictures, and told me to wait in the waiting room. So, I got out my kindle, expecting the typical waiting time – only worse given the line out the door.

I’d barely read one page before my contact signaled for me to follow her into the next room, to fill out some paperwork. She walked me through it – which was generally the typical “new patient” form, only in Mandarin, but asking for the typical medical history stuff. When I completed it, she told me to wait again, then turned the paperwork in and returned to me with a ticket that had a number on it. Just like the DMV – only not.*

*ASIDE: There are multiple instances in which you take a number for services here – going to the mobile phone store, returning items at a store, picking up items at a store. So far, none have been as efficient as the medical exam system, although IKEA comes close, promising a wait no longer than 9 minutes.

My number was about 20 numbers ahead of those flashing on the wall above the next door, so I again pulled out my kindle to settle in for a doctor’s office wait. And, again, I was surprised when my number was called in less than 5 minutes. So, I went through the next door, where clerks checked my paperwork and entered the info I’d written into their computer. I had listed “attorney” as my occupation. The clerk asked me whether I was going to be working as an attorney for a firm here in China. “No.” So, she told me to cross that out and write “housewife.“ Ok … She quickly finished entering the rest of the info, then stapled one of my pics to the documents I’d completed, and handed them to me, directing me to leave out the side door … into a hallway filled with doors.

A young woman dressed in scrubs guided me directly to the next door on the right, where I was to change clothes and put on the gown thing. Now, I’d read about this part: most people take off all clothes down to undies, which is “ok” – unless one is uncomfortable walking around 150 other people with the backside open. The thing is, you can wear shorts, even though they do not explain this. So, anyway, I only partially stripped, put on the little cloth slippers and the gown (opening in front), put my stuff in the locker, and walked back out.

And, then the “exam” began.

First up, Door 107, where a young HCP* took my weight and height, while another recorded it on my papers, then initialed it. About 45 seconds later, she directed me back to the hallway, where the “traffic coordinator” directed me across the hall to Door 108. (There was a stream of coordinators, and a bigger stream of examinees in the hallways at all times.)

*I have no idea whether each person was a medical technician, nurse, doctor, or other, so I’m referring to them all as “HCP” – health care provider.

Behind Door 108, a HCP took my blood pressure and temperature and recorded it on my paper. She also talked through my responses. About 2 minutes later, she directed me back out to the hall.

A coordinator saw me emerging and promptly directed me to Door 110. There, I had to lay down behind a screen. The HCP took my papers, opened the gown and attached electrodes to various spots then went to her computer. About three minutes later, she stapled a printout of the EKG (?) to my chart, signed in her spot, came over and popped the electrodes off, handed me the papers, and pointed towards the door.

Back out in the hall, another coordinator directed me to Door 113. There, after taking my papers, a HCP directed me and then positioned me before an x-ray machine. Once in place, another HCP behind a window took the picture. The HCP signed my papers and directed me back out the door. Total time in Room 113 was less than 5 minutes.

Next up, eye, ears, and throat exam in 120. First the HCP looked in my ears, throat – then paused and looked at my papers again and raised her eyebrows at me. I’d marked “no surgery” – because m immigration counselor said to list only surgeries in the past year. So – I said I misunderstood the question and explained yes, when I was 20 I had my tonsils taken out. She made notes on my chart, and then gave me the eye exam. I couldn’t see the two bottom rows and explained I wore contacts. She made some more notes and then handed me my papers and pointed to the door. Total time in that room – less than 5 minutes.

Another coordinator promptly pointed me to Door 124. There, an HCP was drawing blood from a guy, so told me to wait. (She was the only person of the many who “directed” me through this process that was … less then politely professional. I think she might have been a drill sergeant once or something….) Anyway, she slapped on the band, stuck the needle, and withdrew the guy’s blood in what seemed like less than a minute, then directed me to sit down. Seconds later, the band was on and she was repeating “fist… FIST!!” because I hadn’t made a fist fast enough. (I was staring at her glove, which had a red spot on it – I made the fist only after I confirmed that that was from her red sharpie and not something else…..). In went the needle and out went two vials of blood; on went the gauze and tape with a “Hold for 3 minutes!” With a wave of her hand, I was out of there (and happy to be so!).

Final room was back to 122, where I had to lay down again for a sonogram of my belly. (I’d heard of this as well, and heard that every single American’s medical report included “fatty liver” based on the sonogram…) Here, things slowed down a bit. The HCP started “tsk tsking,” and speaking with a man sitting at the nearby computer, who appeared to be a doctor and certainly was her supervisor. She went over the right side, then the left side of my belly repeatedly, telling me to take a deep breath and hold, again and again. For at least 5 minutes. (Yikes, my apparently very interesting belly was gumming up the works; I could hear more and more people lining up at the door in front of the curtain.) Then, the “supervisor” took over the controls and spent a bit of time going over the same area. After another 5 minutes of this, he appeared to finish, though he took out his camera and took pictures of the screen showing two sonogram photos. Then he said “ok.” And I jumped up and walked past the now 6+ person line out the door.

Back in the hallway, a coordinator said “that’s it, you’re done,” then directed me back to the changing room. I changed clothes and then went back out to the lobby where the helpful immigration counselor took my papers and went to the counter to check out.

And, fifty-five minutes after I’d arrived at the facility, I was out the door.

About a week later, I received the medical report. No fatty liver. Yaaaay!

Yes, that exam certainly took more than 4 people – I’m sure that, between the initial intake clerks, the hallway coordinators, the HCPs and their assistants, my exam took at least 40 different people -- but man was it efficient!!!

(Just because I know someone will ask, the report indicated that I might have a very small kidney stone on each side - which is what the HCP/doctors were looking at on the sonogram. But - fortunatly, I have never had any symptoms and they're apparently very small and all that. Anyway, will take care and pay attention to that just in case but -- really, nothing to worry about.)